Organization
BLOOM BEHAVIOR SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIA RICHARDS BCBA (OWNER)
(407) 758-4948
Entity
Organization
Contact information
Practice address
6239 EDGEWATER DR STE N4, ORLANDO, FL 32810-4736
(407) 900-5532
(321) 244-0645
Mailing address
6239 EDGEWATER DR STE N4, ORLANDO, FL 32810-4736
(407) 900-5532
(321) 244-0645
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018854500
—
FL
Enumeration date
12/14/2017
Last updated
05/28/2024
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